PID can develop when bacteria enter and infect the cervix and then travel up to infect the reproductive organs- the uterus, fallopian tubes and/or ovaries. While PID is most often caused by gonorrhea and chlamydia - two common STIs - it can also be caused by certain procedures that open the cervix and allow bacteria to enter (e.g., a Dilation and Curettage (D&C), abortion, caesarean birth, miscarriage or IUD insertion). Untreated bacterial vaginosis and trichomoniasis can also lead to PID.

Signs & Symptoms

PID can occur suddenly or develop slowly over time.

The most common symptoms include:

Pain in the lower abdomen and/or lower back.

Bloating and/or pressure in the abdomen and/or lower back.

Fever.

Vaginal discharge with an unusual odour and/or colour.

Flu-like symptoms (fever, chills, aching muscles).

Pain during or after intercourse.

Irregular vaginal bleeding.

Frequent and/or painful urination.

Symptoms of PID can be very mild. While some women don’t have any symptoms at all, that doesn't mean that the infection isn’t serious. Make an appointment with your family doctor right away if you think you have PID.

Diagnosis & Treatment

Diagnosing PID

To diagnose PID, your doctor will ask about your symptoms and perform a pelvic exam. During the pelvic exam, your doctor may swab the inside of your cervix. A laboratory will test the sample for gonorrhea and chlamydia.

If this examination is inconclusive, your doctor may order other procedures such as a laparoscopy and/or an ultrasound.

During a laparoscopy, a telescope-like instrument is inserted through an incision in the navel. This lets your doctor view your pelvic organs.

During an ultrasound, a technician will move an electronic device over your abdomen and/or inside your vagina. This lets your doctor see if your reproductive organs are swollen or if you have an abscess.

Treatment

PID can be treated with oral antibiotics. Be sure to tell your doctor if you’re taking birth control pills or any other medications. Some antibiotics don’t work as well if you’re using other medications.

Since PID can be caused by more than one type of bacteria, two or more types of antibiotics might be necessary to completely cure the infection. Your symptoms should improve after 2-3 days. If your symptoms aren’t improving, or if you feel worse, revisit your doctor for another examination. If your infection is severe you might need to be hospitalized to receive antibiotics intravenously.

Good nutrition, rest and reduced activity are important for a full recovery. Also, be sure that all of your sexual partners are treated for any STIs, whether or not they have any symptoms. Don’t have sexual intercourse until you’ve taken all of your medication and your doctor is certain your infection is cured.

Left untreated, PID can cause infertility. The tissue inside the fallopian tubes will become scarred, which can damage the fallopian tubes or block them entirely. This scar tissue can partially block the journey of a fertilized egg, causing it to implant in a fallopian tube. An ectopic pregnancy causes sharp, persistent pain on one side. It can be life-threatening and requires immediate medical attention.

Follow Up and Prevention

Follow Up

It’s important to know that your infection is cured. Your health-care provider will tell you when to return for a follow-up test. Depending on which tests you need, you’ll be asked to return 1-6 weeks after finishing the medication. If you’re menstruating, you shouldn’t be retested until your period ends.

Because most cases of PID are linked to STIs, treating a female’s sex partners is essential to prevent repeat infections. All your recent sex partners should be examined by a doctor and treated if they have gonorrhea and/or chlamydia. A female with PID should not have sex with her sex partners until they have been treated.

Prevention

Your can reduce your risk of developing PID by:

Avoiding sexual intercourse.

Have yourself and all sexual partners tested (and treated if necessay) for STIs before having any sex.

Using condoms every time you have vaginal and/or anal intercourse, using dental dams for oral sex performed on a female and using condoms for oral sex performed on a male.Using a birth control method other than an IUD if you have several sexual partners.

Visiting your doctor regularly for STI testing, especially if you have an IUD and don’t consistently use condoms.

Wiping from front to back after a bowel movement to prevent bowel bacteria from entering your vagina.

More PID Facts

Almost 100,000 Canadian women are diagnosed with PID each year.

Young women are especially at risk. One in eight sexually active 15 year old females will develop PID. Young females are at higher risk because their cervical cells aren’t fully developed yet and are therefore more susceptible to PID.